Cost-Effectiveness of Individualized Management of Diabetes Among U.S. Adults
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The full report is titled “Individualized Glycemic Control for U.S. Adults With Type 2 Diabetes. A Cost-Effectiveness Analysis.” The authors are N. Laiteerapong, J.M. Cooper, M.R. Skandari, P.M. Clarke, A.N. Winn, R.N. Naylor, and E.S. Huang.

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Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.

Hemoglobin is a protein inside red blood cells that helps carry oxygen from the lungs to the rest of the body. Glucose (sugar) in the blood slowly attaches to hemoglobin to form hemoglobin A1c (HbA1c). The more glucose in the blood, the more HbA1c is formed. As a result, the percentage of hemoglobin that is HbA1c reflects the average value for blood sugar during the previous 2 to 3 months. The American Diabetes Association encourages people to use the percentage of HbA1c to keep track of how well their diabetes is being controlled, and until recently doctors would tell people to aim for a target of 7%. But, when everyone has the same target, some people have blood sugar values that are too high and others have values that are too low. As a result, many doctors now increase or decrease the target according to the person's age, medical history, and remaining years of life and how likely they are to have very low blood sugar, which is especially dangerous.